Experience Summary

In this experience, observe the World Health Organization (WHO) briefing for a theatre list in an orthopaedic theatre

Clinical Context

The WHO Surgical Safety Checklist was developed to address preventable harm in the operating theatre, where complex workflows, multidisciplinary teams, and time-pressured decision-making create an environment vulnerable to error. Before the start of a theatre list, the WHO “briefing” (also known as the team brief) plays a crucial role in establishing a shared understanding of the operative plan. This is particularly important in surgical settings where variability in patient complexity, staffing, equipment availability, and emergency cases can influence the smooth running of the day. By bringing the entire team together—surgeons, anaesthetists, nursing staff, operating department practitioners, and theatre support personnel—the briefing ensures that communication is proactive rather than reactive, reducing the likelihood of avoidable intraoperative complications or workflow disruptions.

The importance of the WHO briefing extends beyond simple procedural checks. It enhances patient safety through systematic identification of risks before patients enter the operating room. Discussing case order, anticipated challenges, and specific patient needs allows the team to prepare essential resources, such as specialised equipment or blood products. It also ensures clarity on infection-control requirements, imaging availability, and postoperative plans. By promoting open dialogue, the briefing enables team members to voice concerns and raise potential hazards early, which supports a culture of safety and flattens hierarchical barriers that might otherwise hinder effective communication. Evidence has shown that such briefings improve teamwork, reduce surgical delays, and contribute to lower rates of adverse events.

Components Of The Briefing

The components of the WHO pre-list briefing typically include confirmation of the day’s operating schedule, verification of patient details and surgical procedures, and identification of individuals’ roles and responsibilities. The team reviews key anaesthetic considerations, such as difficult airway alerts or comorbidities, and highlights surgical nuances that may affect equipment needs or case duration. Anticipation of critical steps—such as potential for major haemorrhage, use of prosthetics, or advanced imaging—ensures that theatres are properly prepared. The briefing also covers logistical factors, including instrument availability, sterility concerns, theatre turnaround plans, and escalation pathways should complications arise. Finally, it encourages staff to raise any concerns or uncertainties, reinforcing shared situational awareness.

Learning Outcomes

1. Observe the WHO briefing being used in practice.
2. Increase understanding of the components of the WHO briefing checklist.
3. Observe the roles of the MDT in the WHO briefing checklist.
4. Increase understanding of the importance of using WHO briefing checklists in clinical practice.

External Resources

• World Health Organization – Surgical Safety Checklist (First edition, 2008)
• Royal College of Surgeons – Five steps to safer surgery (adapted version of the WHO checklist used in UK practice)